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General NPI Number Information
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NPI Number | 1750286787
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Entity Type | Organization
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Legal Business Name | SOUL HAVEN COUNSELING OC, INC.
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 145 W MAIN ST STE 200B
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City | TUSTIN
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State | CA
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Zip | 92780-4360
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Country | US
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Telephone | 714-485-7811
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Fax |
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Provider Business Mailing Address
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Address Line | 145 W MAIN ST STE 200B
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City | TUSTIN
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State | CA
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Zip | 92780-4360
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Country | US
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Telephone | 714-485-7811
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | KRISTEN JOHNSON
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Credential | LPCC
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Telephone | 714-485-7811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | NULL
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